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TMC EXAM A QUESTIONS AND VERIFIED SOLUTION LATEST UPDATE.
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TMC EXAM A QUESTIONS AND VERIFIED SOLUTION LATEST UPDATE.
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TMC EXAM A QUESTIONS ANDVERIFIED SOLUTION LATEST UPDATE
A .48 .year-
old .female .is .admitted .to .the .ED .with .diaphoresis, .jugular .venous .distension, .and .3+ .pitting .edema .i
n .the .ankles. .These .findings .are .consistent .with .- .(correct .answer) .-heart .failure
A .patient .is .admitted .to .the .ED .following .a .motor .vehicle .accident. .On .physical .exam, .the .respirator
y .therapist .discovers .that .breath .sounds .are .absent .in .the .left .chest .with .a .hyperresonant .percussio
n .note. .The .trachea .is .shifted .to .the .right. .The .patient's .heart .rate .is
.45/min, .respiratory .rate .is
.30/min, .and .blood .pressure .is .60/40 .mm .Hg. .What .action .should .the .therapist .recommend .first? .- .
(correct .answer) .-Needle .aspirate .the .2nd .left .intercostal .space
All .of .the .following .strategies .are .likely .to .decrease .the .likelihood .of .damage .to .the .tracheal .mucos
a .EXCEPT .- .(correct .answer) .-using .a .low .residual .volume, .low .compliance .cuff
A .52 .year-old .post-
operative .cholecystectomy .patient's .breath .sounds .become .more .coarse .upon .completion .of .postura
l .drainage .with .percussion. .The .respiratory .therapist .should .recommend .- .(correct .answer) .-
deep .breathing .& .coughing .to .clear .secretions
A .65 .kg .spinal .cord .injured .patient .develops .atelectasis. .His .inspiratory .capacity .is .30% .of .his .predict
ed .value. .What .bronchial .hygiene .therapy .would .be .most .appropriate .initially? .- .(correct .answer) .-
IPPB
A .healthy .adult .female .can .exhale .what .portion .of .her .forced .vital .capacity .in .the .first .second? .- .
(correct .answer) .-70%
A .patient .on .VC .ventilation .demonstrates .auto-
PEEP .on .ventilator .graphics. .Which .of .the .following .controls, .when .adjusted .independently, .would .in
crease .expiratory .time?
1. .Tidal .volume
2. .respiratory .rate
,3. .inspiratory .flow
4. .sensitivity .- .(correct .answer) .-1, .2, .and .3 .only
Which .of .the .following .would .be .the .most .appropriate .therapy .for .a .dyspneic .patient .who .has .crepi
tus .with .tracheal .deviation .to .the .left .and .absent .breath .sounds .on .the .right? .- .(correct .answer) .-
insert .a .chest .tube
Following .cardiac .surgery, .a .55 .year-
old .patient .has .the .following .ABG .results: .pH .7.50, .PaCO2 .30 .torr, .PaO2 .62 .torr, .HCO3 .25
.mEq/L, .SaO2 .92%, .HB .14 .g/dL, .BE .
+2. .Venous .blood .gas .results .are .pH .7.39, .PvCO2 .43 .torr, .PvO2 .37 .torr, .and .SvO2 .66%. .Calculate .th
e .patient's .C(a-v)O2. .- .(correct .answer) .-5.0 .vol .%
A .patient .on .VC, .SIMV .with .a .VT .of .500 .mL .has .a .PIP .of .25 .cm .H2O, .Pplat .of .15 .cm .H2O .and .PEEP .
of .5 .cm .H2O. .What .is .the .patient's .static .lung .compliance? .- .(correct .answer) .-50 .mL/cm .H2O
Immediately .after .extubation .of .a .patient .in .the .ICU, .the .respiratory .therapist .observes .increasing .re
spiratory .distress .with .intercostal .retractions .and .marked .stridor. .The .SpO2 .on .40% .oxygen .is .noted .
to .be .76%. .Which .of .the .following .would .be .most .appropriate .at .this .time? .- .(correct .answer) .-
Reintubation
Which .of .the .following .patients .would .most .likely .benefit .from .pressure .support .ventilation? .- .
(correct .answer) .-A .patient .on .SIMV .with .a .mandatory .rate .of .12/min .and .total .rate .of .24/min.
A .patient .receiving .mechanical .ventilation .has .developed .a .temperature .of .99.9° .F .with .purulent .sec
retions .over .the .last .12 .hours. .The .respiratory .therapist .has .also .noted .a .steady .increase .in .peak .ins
piratory .pressure. .What .initial .recommendation .should .be .made .to .address .these .changes? .- .
(correct .answer) .-obtain .a .sputum .gram .stain
Which .of .the .following .information .may .be .obtained .from .a .FVC .maneuver .during .bedside .pulmona
ry .function .testing? .
1. .FEV1 .
2. .PEFR .
3. .FRC .
4. .RV .- .(correct .answer) .-1 .& .2 .only
The .respiratory .therapist .provides .education .for .a .patient .who .is .being .discharged .home .on .aerosol .
therapy. .The .most .important .reason .for .the .patient .to .follow .the .recommended .cleaning .procedure
s .using .a .vinegar/water .solution .is .that .this .solution .will .- .(correct .answer) .-retard .bacterial .growth
A .patient .who .complains .of .dyspnea .is .noted .to .have .a .dry, .non-
productive .cough. .On .physical .examination, .breath .sounds .are .diminished .on .the .right, .tactile .fremit
, us .is .decreased .and .there .is .dullness .to .percussion .over .the .right .lower .lobe. .The .respiratory .therap
ist .should .suspect .that .the .patient .is .suffering .from .- .(correct .answer) .-pleural .effusion
Which .of .the .following .suction .catheters .would .be .appropriate .to .use .for .a .patient .with .a .size .8.0 .
mm .ID .endotracheal .tube? .- .(correct .answer) .-12 .Fr
A .patient .who .is .receiving .continuous .mechanical .ventilation .is .fighting .the .ventilator. .His .breath .so
unds .are .markedly .diminished .on .the .left, .there .is .dullness .to .percussion .on .the .left, .and .the .trache
a .is .shifted .to .the .left. .The .most .likely .explanation .for .the .problem .is .that .- .(correct .answer) .-
the .endotracheal .tube .has .slipped .into .the .right .main .stem .bronchus.
The .respiratory .therapist .notes .a .developing .hematoma .after .an .arterial .blood .gas .was .drawn .from .
the .right .radial .artery. .The .immediate .response .is .to .- .(correct .answer) .-apply .pressure .to .the .site
A .patient's .breathing .pattern .irregularly .increases .and .decreases .and .is .interspersed .with .periods .of .
apnea .up .to .1 .minute. .Which .of .the .following .conditions .is .the .most .likely .cause .of .this .problem? .- .
(correct .answer) .-elevated .intracranial .pressure
What .value .for .the .apnea-hypopnea .index .(AHI) .is .consistent .with .mild .obstructive .sleep .apnea? .- .
(correct .answer) .-5 .to .15
While .monitoring .a .newborn .utilizing .a .transcutaneous .monitor, .the .respiratory .therapist .notices .a .c
hange .in .PtcO2 .from .60 .to .142 .torr .and .simultaneously .the .PtcCO2 .changes .from .37 .to .2 .torr. .Wha
t .is .the .most .likely .explanation .for .these .changes? .- .(correct .answer) .-air .leak .around .the .sensor
A .patient .on .the .general .medical .ward .receives .oxygen .via .28% .air .entrainment .mask .with .the .flow
meter .set .at .5 .L/min. .What .is .the .total .flow .delivered .to .the .patient? .- .(correct .answer) .-55 .L/min
Which .of .the .following .measurements .is .most .indicative .of .congestive .heart .failure? .- .
(correct .answer) .-pulmonary .capillary .wedge .pressure .of .30 .mmHg
Sleep .apnea .can .be .defined .as .repeated .episodes .of .complete .cessation .of .airflow .for .- .
(correct .answer) .-10 .seconds .or .longer
A .patient .in .the .ICU .receiving .mechanical .ventilation .underwent .fiberoptic .bronchoscopy .during .whic
h .a .tissue .biopsy .was .collected. .Immediately .following .the .procedure, .the .respiratory .therapist .note
s .that .the .peak .inspiratory .pressure .on .the .ventilator .has .increased. .Potential .causes .for .this .include
.all .of .the .following .EXCEPT .- .(correct .answer) .-hypoxemia
What .size .endotracheal .tube .would .be .appropriate .for .an .adult .female .patient? .- .(correct .answer) .-
7.0 .to .7.5 .mm
The .respiratory .therapist .is .asked .to .evaluate .the .presence .of .Auto-
PEEP .on .a .patient .receiving .mechanical .ventilation. .In .order .to .do .this, .the .therapist .should .- .
(correct .answer) .-initiate .an .expiratory .hold .just .prior .to .the .next .ventilator-delivered .breath.
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